Ineffective health self-management: a systematic review and meta-analysis of aetiological factors in adults with cardiovascular conditions

无效的健康自我管理:成人心血管疾病病因因素的系统评价和荟萃分析

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Abstract

BACKGROUND: Promoting health self-management is an essential component of nursing care for maintaining quality of life in individuals with cardiovascular conditions. AIMS: This systematic review aimed to identify aetiological factors associated with ineffective health self-management (IHSM) in adults with cardiovascular conditions. METHOD: Systematic review of aetiological factors. Databases: Medline, Web of Science, CINAHL, Scopus, and LILACS in July 2024. Combined key terms: adult, health risk behaviours, self-management, and cardiovascular diseases (CVDs). Inclusion criteria: adults with cardiovascular conditions and aetiological factors for IHSM. Exclusion criteria: acute disease exacerbations, intensive, palliative, or immediate post-surgical settings. All included studies were critically appraised for bias using the relevant assessment tools. Data were synthesised according to the theory of causation and validation of nursing diagnoses, and a meta-analysis was performed. RESULTS: Forty-five studies were included, predominantly cross-sectional studies, clinical trials, and cohort studies. The most common cardiovascular conditions addressed were systemic arterial hypertension and congestive heart failure. Thirty-five potential factors associated with IHSM were identified and categorised in factors: predisposing, disabling, precipitating, and reinforcing. CONCLUSIONS: The identified factors provide insights for nursing practice when caring for patients with cardiovascular conditions and contribute to scientific knowledge by highlighting patient self-management needs. IMPLICATIONS FOR NURSING PRACTICE: This review identifies novel aetiological factors that should be integrated into nursing care plans for patients with CVD. It also validates and expands upon related factors within the NANDA-I taxonomy. Critically, our findings underscore the value of using theory to clarify the origins of a nursing diagnosis, enabling nurses to identify more precisely the root causes of ineffective health self-management.

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